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AP�LICAYIf'�+1 FOR CONSTRUC'�N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAH STAEEI' • EVERETT, WA 982 • 9•HB10 <br />9 <br />❑ DEMOLITION � COMBINATION � BUILDING �;AECH IC:AL PL MBING O SIGN <br />PROJECTADDRESS: �L./3 �C�`U�'L� ,�LU� /=��:�'L-'" lC�-`1�:���? <br />' i � � <br />,7�2/_ d .%inu�la P_Ai;AINT / /_/'� �I-. �Fn/.. /dlil�. L�u:= r.'ETT l! 11 9,Y.a.J ? , �d_. � i5,3 -U.� � � <br />��r�7NG. <br />TENANT 4MlI�Wt1C55 GtY lIP PnONE <br />�E.�ic ��� �iivcS -/9i� Nr�n,s��v Si, t���=a'GTT ic.%��. 9,�':,u3 '.�?uG� ,?S �-OJ3/ <br />MILIMTECT OR DESIGNFN Meil �DDnE55 CITY—��71P nNONF. <br />NA�esr�D ('oNStn.uanor:�-aK:�c �G%`' �sF. F_U.r•,��rrr; (,c(,c. `I�,Zo�! (�� 3.37- 5'c�.s"'� <br />GENEML CONIMCTOf1 MAILM�fiE55 CIIY l�� ���ONE SI�TE IICENSE � <br />MEpIN11C�LCONTR�LIOR M/uLADDRE55 f.11v Iil` PIIONE SUTEIiCENSE� <br />PLUMBWGLONIR�LT011 MAIIApIXIE55 LIIY ZIP PNONE Sf�TEL�GENSE� <br />�� <br />WOIIN �ND <br />/i_ <br />IEOILL OESLiUP110N OF P110PERtt <br />LO7 � &OCN _ <br />/l�E/-T� L <br />� <br />%. <br />�i: �LRT /�G:�ncAP� _ L�✓uNE /O J� <br />�G .�y��xas �F � ito HcNisJ� (; <br />PARCELU%ID MIMBEP <br />A /�2rioN �L S3i� - 0.�0=0, <br />CONSTIIULTONLOANIEN .�OORESS.TElEP110NENUUBEN <br />Ro. ao� 7 yo <br />PLUMBIN6 <br />flXTURE OR ITEM <br />WATER Ci <br />BATHTUB <br />SHOWER <br />KITCHEN SINK 8 DISP <br />CLOTHES WASHEH <br />UR�NAL <br />BACKFLOW PREVENTERS <br />CINK fCFRVIf:F _ RAR Fl <br />FOR OFFICE USE ONLY: <br />FRONTSETB�CN / PE�R SFiI <br />USE20hE LOI�NEA <br />�-Z <br />HE�OIIi LIMIT�i1 <br />�KCIIPANCY N <br />R(T1P <br />�'� � <br />F'RE 5� <br />FINE �I/J M 0 <br />� <br />TrPE O� rov5r <br />�� � <br />- 000 � <br />FEE <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />CON7�CIFENSON�NOPNONENO <br />i��,��,,,� c�6�u,�:r ,��� _�.s <br />I HEREBY CEHTIFY THAT I HAVE READ AND E7CAMIPIED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALl <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIE[1 HCREIN OR <br />NOT. THE 6RANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PqOVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGUUTINO CONSTRUCTION OH THE <br />PERFOFMANCE OF CONSTRUCTION. THAT I AM 4UTMORRED BV THE <br />OWNER OF THIS PROPERTV TO PERFOFM TNE WORK FOR WHICH <br />APPLICATION IS MADE 4ND 1 COMPIV WITH THE STATE <br />CONTRACTORS LAW 1027 .iCW AND 296200 WAC. <br />x _�or�»�., � ni��u T iu�..��fG <br />SIGNAfU � O�TE <br />qTY BUSINESS IICENS[ NO <br />NO. � TYPE OF EOUIPMENT � FEE <br />FORCED AIR <br />HEAT PUMP <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />GASRANGE <br />SUBTOTAL S ; sun i�in� a ; <br />PERMIT f � PERMIT S � <br />TOTALFEE S ' TOTAL FEE S ' <br />.7 � ! � o� <br />. <br />LR ./ SIDESETB/�CN f PUNCIIECRNUYOFf1 fEF RECEIPTFO <br />! V � � <br />V�C�Ht S��E FEES VALUATION FEE <br />_ ❑ves ❑ No omioiNr i� fl � /� , �' /i/ 4G,5 // /,� � �`� <br />NO OF OWELUH6 <br />UNIIS � <br />OLCUP�NfL0�0 <br />OAIE <br />lf. LIV��JC� -F P111Y0iN0 � �/�� <br />: Gn2Fac,E t-� <br />MENT � <br />� � MECII�HIC.M. --� /� (7 i(7.�1 <br />❑vE5 L�T+� <br />�OO�IIONN PIAN CI�fLN � <br />O111E11 { <br />STAIEOOIl01N6511tIC1Ut1fE — /r i • -� <br />��� CITY OF EVEflETT runur, wonKs � �� ;� <br />LOCALSALES — �j _ <br />i� TAX CODE IS 3105 70TAL / y���J ��� <br />